INFECTIONS – Cautionary Tales

KEEPING THE FEET SWEET (updated 2/2013)

I wear riding boots or closed shoes every day on the farm in Hawaii’s tropical climate. Some years ago I noticed that I was getting a burning sensation on the top surface of my feet and a tendency to get something nasty happening between my toes, even if I dried them really well . I tried all the human foot care preparations. The results were so-so. Then I tried Fungisan, a horse anti-fungal on my feet every morning and that worked better than anything I had tried. One day I was reading up on animal care and chanced upon a statement about the use of vinegar as an anti-fungal. I began splashing vinegar on my feet every morning before I put on my socks. The vinegar did the trick. If I miss a couple of days, my feet start to burn again, but it clears up immediately when I use the vinegar again. It also seems to have improved since I have drastically reduced the amount of sugar I consume, improved my intake of essential fatty acids and generally upgraded my diet and supplements.

CENTIPEDE BITE CELLULITIS (updated2/2013)

or The Centipede Bite That Turned to Some Kind of Nasty “itis” (cellulitis or even mild fasciitis, maybe) October 2009 How I fixed it.

I was spreading wood chips in the horse pens when I felt the unmistakeable sting of a centipede bite on my ankle inside my boot. I quickly removed my boot but did not find the offending critter. Since it didn’t hurt a great deal, I just ignored it and went on working. Later in the day, I had forgotten that it happened, but my foot started to hurt as though I had sprained a muscle. I knew that I had not done anything of the sort, so I decided to go riding, thinking that it would work itself out. Bad move! By the time I got back, it was hurting so much that it was all I could do to put the tack away, feed the horses and limp to the house.

Thinking that it may indeed have been a sprain, I tried to decide whether to apply warmth or ice it down. I decided to take a warm bath while I pondered what was going on. At some point it dawned on me that this was the foot on which I had had the mysterious bite. Then I wondered if the warm treatment might not help the venom to spread. So I tried pain meds and ice for a while and groaned a lot. The next day, my foot was significantly swollen all around below the ankle and each successive day for a week it was more swollen each day. I took to wearing an ace bandage and wearing a Croc on that foot. I could bear weight on the foot, but I could had to limp along like Chester in Gunsmoke (for those who remember that TV series). I couldn’t flex the foot at all, curl my toes. or anything, without a lot of pain.

At a certain point I could clearly see the two bite marks in the swollen tissue on my ankle. I did some research online on centipede bites. I was heartened to know that no-one dies from them and that the symptoms can be variable in type and severity. I took OTC pain meds all the time, slept a lot and waited for the swelling to go down thinking that it was resulting from the action of the venom. The swelling continued to increase and spread. My toes were starting to get that stretched sausage look. I went back to do some more online research. That’s when I found out about gems like eosinophilic fasciitis, compartment syndrome and that a man in Turkey had died from nectrotizing fasciitis after being bitten by a centipede. Any normal person would probably have thrown the problem at an MD at this point, but I thought that I did not have one of the heavy duty bacterial infections, but that I seemed to have a spreading “itis”. So I turned back to what I know, how to treat dog and horse injuries. I began to do warm compresses, 40 minutes, 4 times per day. Actually I ran a warm shallow bath with Epsom Salts and Hot, Noni Lavender lotion in the water. The Noni – Lavender may not have done anything for my foot, but the lavender smelled great. My foot was very sensitive to the heat so I had to gradually build up the warmth. I used two, water-soaked. facecloths which I wrapped around the foot and the ankle to keep the areas warmed. Using the washcloth to disperse the pressure, I massaged the parts of the foot where the swelling seemed to have underlying stiff areas, to break up these stiff areas. I also started to try moving the food to do thing like curl my toes, point, or push the heel down, or bring up my toes. It was all painful and I couldn’t move it much at first. The next morning, there was visible improvement, so I kept doing it, sometimes getting up at 3:30 a.m. to work on my foot. I also used my therapeutic laser device and that seemed to help with the pain, particularly at night. Interestingly, it

It seemed to me that as I was breaking up the swollen, inflamed areas, I began to have some headaches as though my system was dealing with a toxic load. That happened in waves and each time I drank lots of fluids and rested if I felt tired. After about four days,the swelling was down enough so that I could get the foot and ace bandage into my boot with the laces greatly extended. I started walking more and trying to flex the foot. I was still really vulnerable to taking a wrong step on rough terrain and triggering a big pain jolt as a part that was stuck came unstuck.

Just over three weeks from the bite, my foot felt well enough to take my mare, Sygnet on a 15 minute walk in hand up the trail. That went well. But the next day, I worked hard carrying beehives all day. The following morning, my foot felt okay, but started to hurt while I was feeding the horses. Several hours later I was in such pain, even with OTC pain killers, that I couldn’t stand up, and had to be lifted into the car and carried to the house. I won’t detail my stubborn insistence on continuing to treat myself, but suffice to say, I ended up in the E.R. , was admitted, and spent 5 days in hospital on IV antibiotics. I was released to home with a central line installed for another five weeks of IV antibiotics and rest. When the infectious disease specialist said that we could stop the antibiotics, I was ordered to increase activity very, very slowly. He told me that unresolved pockets of infection could flare up, as long as a year later. Fortunately, the recovery was long but uneventful and there were no flareups.

What is the moral of this story? I think it is to treat centipede bites with serious, warm compresses/gentle massage from the get go. The researchers think that centipede venom may break down with warmth. If, after the initial 4 hours, the area gets very painful and starts swelling you really ought to consider seeing a doctor. You want to make sure that he/she IDs the bugs involved to make sure you are treated with the right antibiotics. Throughout, use warm compresses. You may have to use a protective coating, like Udderly Smooth, to protect your skin if it dries out and becomes crusty.

CELLULITIS FROM TILAPIA SPINE

FYI, Glenn got cellulits on his leg from being “spined” by a tilapia while transferring fish from our breeding pond to our aquaponic system fish tanks. The additional moral of the story is to wear eye protection, thick gloves and a protective suit when doing harvesting tilapia. Streptococcus iniae is one of the main pathogen hazards involved. Dr. Allen Riggs, the State aquaculture vet alerted us to this bacteria.

Streptococcus iniae can cause invasive cellulitis and in some cases other problems such as endocarditis. If you get spined by a tilapia, get medical help as soon as possible and make sure your doctor knows that you may have been exposed to Streptococcus iniae and uses the appropriate antibiotic. The doctor treating Glenn also directed him to do warm compresses on the leg.